TY - JOUR
T1 - The Vascular Interventions and Surgery in Trauma Audit (VISTA)
T2 - A Prospective National Service Evaluation of Vascular Trauma in the UK
AU - Hurndall, Katherine Helen
AU - Leatherby, Robert
AU - Waton, Sam
AU - Hunter, Ian
AU - Pherwani, Arun
AU - Glasgow, Simon
AU - Davenport, Ross
AU - Gwilym, Brenig L.
AU - Al-Saadi, Nina
AU - Ambler, Graeme K.
AU - Benson, Ruth A.
AU - Birmpili, Panagiota
AU - Bosanquet, David C.
AU - Cai, Paris
AU - Dattani, Nikesh
AU - El-Sayed, Tamer
AU - Hawthornthwaite, Emma
AU - Hitchman, Louise
AU - Nandhra, Sandip
AU - Onida, Sarah
AU - Saratzis, Athanasios
AU - Shalhoub, Joseph
AU - Singh, Aminder
AU - Renwick, Bryce
AU - Gannon, Martin
AU - Sethi, Akshay
AU - Taylor, John
AU - McKinney, Rachel
AU - Cisack, James
AU - Healy, Donagh
AU - Khan, Sifat
AU - Akhtar, Tasleem
AU - Coulson, Rachael
AU - Beattie, Daclan
AU - Barker, Tom
AU - Halliwell-Ewen, Mycroft
AU - Selby, Angus
AU - Beckitt, Timothy
AU - Zywicka, Ewa
AU - Chopra, Ankita
AU - Wijaya, Anthony
AU - Kreckler, Simon
AU - Chowdhury, Mo
AU - La'Torre, Guglielmo
AU - Begbie, Jacob
AU - Meecham, Lewis
AU - Suttie, Stuart
AU - Strachan, David
AU - McGowan, Dominic
AU - Davies, James
N1 - Publisher Copyright:
© 2025 The Author(s)
PY - 2025/8/25
Y1 - 2025/8/25
N2 - Objective: The frequency, operative management, and outcomes for patients with traumatic vascular injury in the UK are unknown. The Vascular Interventions and Surgery in Trauma Audit (VISTA) aimed to describe the contemporary landscape of UK vascular trauma compared with retrospective data from the National Vascular Registry (NVR). Methods: A prospective, resident led service evaluation was conducted across UK major trauma centres (MTCs) delivered by the National Trauma and Research Innovation Collaborative and the Vascular and Endovascular Research Network. The evaluation included patients with traumatic injuries to named vessels falling under the management remit of vascular surgery, identified radiologically or intra-operatively, between March and October 2022 and comparative NVR data from 2017 to 2022. Results: VISTA captured 302 patients with 339 vascular injuries from 27 MTCs. The median patient age was 41 years (interquartile range 26, 59) and 78.8% (n = 238) were men. Most injuries resulted from road traffic collisions (42.4%, n = 128). Overall, 38 patients (12.6%) were shocked on arrival at the emergency department. Two thirds of patients (65.6%, n = 198) required surgery, of whom 140 (70.7%) had an open procedure and 58 (29.3%) an endovascular intervention. Open procedures included 86 (61.4%) extremity interventions (including six [4.3%] primary amputations), four (2.9%) carotid repairs, four (2.9%) caval repairs, and two (1.5%) aortic repairs. Endovascular procedures included 23 (40%) thoracic endovascular aortic repairs, two (3%) extremity stents, and one (2%) extremity embolisation. The secondary amputation rate was 12% (10 of 86). Extrapolated annual VISTA data suggest the NVR fails to capture 58% of aortic injuries and 42% of extremity vascular injuries requiring intervention. Conclusion: UK wide registries do not accurately capture surgical volume and outcomes for vascular interventions following trauma. Granular national datasets are required to establish evidence based key performance indicators for life and limb salvage following vascular trauma to improve services, promote safety, and assure patient outcomes.
AB - Objective: The frequency, operative management, and outcomes for patients with traumatic vascular injury in the UK are unknown. The Vascular Interventions and Surgery in Trauma Audit (VISTA) aimed to describe the contemporary landscape of UK vascular trauma compared with retrospective data from the National Vascular Registry (NVR). Methods: A prospective, resident led service evaluation was conducted across UK major trauma centres (MTCs) delivered by the National Trauma and Research Innovation Collaborative and the Vascular and Endovascular Research Network. The evaluation included patients with traumatic injuries to named vessels falling under the management remit of vascular surgery, identified radiologically or intra-operatively, between March and October 2022 and comparative NVR data from 2017 to 2022. Results: VISTA captured 302 patients with 339 vascular injuries from 27 MTCs. The median patient age was 41 years (interquartile range 26, 59) and 78.8% (n = 238) were men. Most injuries resulted from road traffic collisions (42.4%, n = 128). Overall, 38 patients (12.6%) were shocked on arrival at the emergency department. Two thirds of patients (65.6%, n = 198) required surgery, of whom 140 (70.7%) had an open procedure and 58 (29.3%) an endovascular intervention. Open procedures included 86 (61.4%) extremity interventions (including six [4.3%] primary amputations), four (2.9%) carotid repairs, four (2.9%) caval repairs, and two (1.5%) aortic repairs. Endovascular procedures included 23 (40%) thoracic endovascular aortic repairs, two (3%) extremity stents, and one (2%) extremity embolisation. The secondary amputation rate was 12% (10 of 86). Extrapolated annual VISTA data suggest the NVR fails to capture 58% of aortic injuries and 42% of extremity vascular injuries requiring intervention. Conclusion: UK wide registries do not accurately capture surgical volume and outcomes for vascular interventions following trauma. Granular national datasets are required to establish evidence based key performance indicators for life and limb salvage following vascular trauma to improve services, promote safety, and assure patient outcomes.
KW - Epidemiology
KW - Trauma
KW - United Kingdom
KW - Vascular surgery
UR - https://www.scopus.com/pages/publications/105022121486
U2 - 10.1016/j.ejvs.2025.08.040
DO - 10.1016/j.ejvs.2025.08.040
M3 - Article
C2 - 40865869
AN - SCOPUS:105022121486
SN - 1078-5884
JO - European Journal of Vascular and Endovascular Surgery
JF - European Journal of Vascular and Endovascular Surgery
ER -